Interpolation flaps and determination of pedicle separation time

Abstract

Objectives: Interpolation flaps are applied with their pedicle to import donor tissue from non-adjacent sites to the defect area. These flaps require two-stage surgeries, the second of which is indispensable. The interval between both procedures must be kept as short as possible. Following surgery, it is considered to be beneficial for the patient’s comfort to decrease the duration of hospitalization. Methods: We performed the interpolation flap procedures as a method for repairing various tissue defects in 79 cases both retrospectively and prospectively. Twelve of the cases were forehead flaps, 4 of them were Tagliacozzi flaps, 23 cases were abdominal flaps, 9 cases were cross-finger flaps, 1 case was a reverse cross-finger flap, 5 cases were Abbe flaps, 4 cases were tongue flaps, 7 cases were groin, and 14 cases were sural flaps. We checked the perfusion of the clamped flaps intraoperatively with indocyanine green. Results: We managed to separate the flap pedicle after a minimum of 6 days and a maximum of 14 days. Before separation, all flaps were clamped intraoperatively and if the flaps showed perfusion with indocyanine green, flap separation was performed. The sural flaps were separated after a minimum of 21 and a maximum of 24 days. In no case did flap necrosis occur after separation. No patient received physical therapy in the postoperative period. Conclusion: Some experimental studies in addition to clinical trials and our study all show that unnecessary prolonging of the separation time of interpolation flaps can be avoided.